Mehanna leads New Global Rules to Guide Treatment When Cancer Breaks Out of the Lymph Node

When head and neck cancer spreads to lymph nodes, doctors look to see if cancer cells have broken out of the node into the surrounding tissue. This is called extranodal extension and is linked to a higher risk of the cancer coming back or spreading, so it often triggers stronger treatment (for example, adding chemotherapy to radiotherapy after surgery). Until now, different hospitals and pathologists have used different definitions, which leads to confusion in research and in patient care.This paper brought together 19 expert pathologists from 15 countries to agree on clear, shared rules. They defined exactly what counts as extranodal extension and what does not, how to recognise “soft tissue metastasis”, how to deal with tricky situations (like biopsy changes), and how much should be reported (minor vs major spread, number and size of affected nodes). These standards should make reports more consistent worldwide and help doctors choose treatments more reliably.